摘要
目的探讨气道Y型单子弹头一体化自膨式金属覆膜支架(简称Y型单子弹头覆膜支架)置入治疗右主支气管残端瘘(也称支气管胸膜瘘)的可行性和疗效。方法根据右主支气管残端瘘残留段支气管较短的特殊解剖结构与病变特点,设计出气道Y型单子弹头覆膜支架。X线监视下,对17例患者置入17枚Y型单子弹头覆膜支架。结果气道支架均一次性置入成功,17例患者瘘口支架置入后均获得完全封堵,随访1～34个月。2例术后1～2周内死于顽固性肺部感染和全身衰竭;5例瘘口愈合;10例右胸膜残腔较术前明显缩小,其中2例拔出胸腔引流管,8例带胸膜腔外引流管生存至今。结论气道Y型单子弹头覆膜支架能够完全封堵右主支气管残端瘘,技术可行,近期疗效可靠,值得进一步推广应用。
Objective To investigate the clinical feasibility and efficacy of Y-shaped single plugged airway covered stent implantation in treating right main bronchial stump fistula. Methods According to the special anatomic structure and lesion＇s morphologic feature of the right main bronchial stump fistula, the authors designed a Y- shaped single plugged covered metallic stent to treat this disorder. Under the fluoroscopic monitoring, a total of 17 Y-shaped single plugged airway covered stents were implanted in 17 patients with right main bronchial stump fistula. Results Stent implantation was successfully accomplished with single manipulation in all 17 patients. After the stenting treatment, complete occlusion of the fistula was obtained in all patients. The patients were followed up for 1 - 34 months. Two weeks after the treatment, two patients died of pulmonary infection and general asthenia even though their fistulas had been completely blocked. Healed fistula was seen in 5 patients. In the remaining 10 patients the residual right pleural cavity decreased remarkably in size after the treatment. Of these 10 patients, the intrathoracic drain tube was removed in two and the thoracic drain tube was retained so far in eight. Conclusion The placement of Y- shaped single plugged covered metallic stent can completely obstruct the right main bronchial stump fistula. The technique is feasible with reliable short-term effect. Therefore, this therapy should be recommended in clinical practice.（J Intervent Radiol, 2013, 22： 046-049）
出处
《介入放射学杂志》
CSCD
北大核心
2013年第1期46-49,共4页
Journal of Interventional Radiology
关键词
支气管胸膜瘘
内支架
Y型
介入放射学
bronchopleural fistula
inner stent
Y-shape
interventional radiology
